Healthcare Provider Details

I. General information

NPI: 1306609235
Provider Name (Legal Business Name): AMBER NICOLE YADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12235 BEACH BLVD STE 107
STANTON CA
90680-3962
US

IV. Provider business mailing address

17216 SATICOY ST # 141
VAN NUYS CA
91406-2103
US

V. Phone/Fax

Practice location:
  • Phone: 714-786-6383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: